This informal CPD article ‘Non‑Communicable Diseases in Emergencies: A Public Health Issue’ was provided by The International Academy of Public Health (IAPH), a multi-disciplinary academy dedicated to advancing the global public health workforce.
When a cyclone makes landfall or an armed conflict dominates the headlines, we picture collapsed buildings and crowded field hospitals. What the cameras rarely capture are the quieter crises unfolding in the background: the woman whose insulin ran out when the power failed, the hypertensive grandfather who lost his tablets in the evacuation, or the child whose asthma worsened because smoke and dust permeated the shelter.
Non‑communicable diseases (NCDs), such as cardiovascular disease, diabetes, chronic respiratory illness, and cancer, are no longer confined to affluent societies. They now account for 74% of global deaths, with the largest share occurring in low‑ and middle‑income countries (WHO, 2024). In the Eastern Mediterranean Region (EMR), NCD mortality already exceeds the world average, reaching 79% in some countries (EMPHNET, 2023). When disaster strikes, this silent burden becomes deafening.
Why Are People with NCDs Uniquely Vulnerable?
NCDs share features that make individuals particularly vulnerable to the shocks of an emergency. These diseases require uninterrupted, often lifelong treatment; many rely on refrigeration (e.g., insulin) or advanced medical devices (e.g., dialysis machines); and acute flare-ups, such as heart attacks, strokes, or severe asthma, demand immediate specialist care. Research shows that heart attacks and strokes can be two to three times more frequent following a disaster (WHO, 2024; Chan & Kim, 2011).
Emergencies Magnify Risk through Three Interlocking Pathways:
- Physical injury interacting with chronic illness can precipitate life-threatening complications.
- Degradation of living conditions, including loss of shelter, safe water, appropriate food for special diets, and secure medication storage, undermines daily self-management.
- Interruption of treatment, due to damaged health facilities, broken supply chains, and a shortage of trained personnel or power, can be fatal. Even brief lapses may endanger individuals who depend on insulin, dialysis, or anticoagulation therapies (WHO, 2016).
Turning Commitments into Practice
Momentum is growing. The 75th World Health Assembly (2022) called on Member States to protect the 1.7 billion people living with NCDs in humanitarian crises. Building on this, WHO, UNHCR, and other partners convened a high-level technical meeting in Copenhagen in February 2024 to translate these commitments into operational guidance (WHO, 2024). Despite progress, critical gaps remain, especially in funding, dialysis and cancer care, and the training of frontline workers to manage chronic illness alongside trauma and infectious diseases. Bridging these gaps demands urgent investment, capacity-building at local levels, and the integration of chronic care into all emergency preparedness and response protocols. This momentum is also reflected in the EMR's Regional Framework for Action on Addressing NCDs in Emergencies (WHO EMRO, 2023), which outlines key strategies for integrating NCDs across all phases of emergency management. It aligns with global efforts such as the Copenhagen Statement, reinforcing the need to prioritize chronic disease care in crisis settings.
What Can Be Done Now?
Integrating NCD preparedness into emergency response requires foresight, training, and inclusion. Public health professionals should advocate for NCD care in disaster risk reduction strategies, ensure stockpiles of essential medications, and train emergency responders to identify and manage chronic conditions. At the policy level, health systems must embed NCD services into universal health coverage frameworks, particularly in fragile and conflict-affected settings. Tools such as the WHO NCD Kit and PEN protocols offer practical, scalable entry points (WHO, 2010).
Conclusion
As climate change, conflict, and demographic pressures intensify, disasters are expected to become more frequent and severe. Protecting people with NCDs can no longer be treated as an optional humanitarian add-on, it is essential for achieving Universal Health Coverage and for preventing avoidable deaths. By preparing for chronic conditions before disasters strike, ensuring treatment continuity during the crisis, and rebuilding stronger systems post-emergency, we can prevent the silent emergency of NCDs from becoming the loudest tragedy of the next disaster.
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References
- Chan, E. Y., & Kim, J. (2011). Chronic health needs immediately after natural disasters—Sichuan earthquake. European Journal of Emergency Medicine, 18(2), 111–114.
- Eastern Mediterranean Public Health Network (EMPHNET). (2023). Addressing the Burden of Non‑Communicable Diseases in the Eastern Mediterranean Region: Policy Brief.
- WHO EMRO. (2023). Framework for Action on Addressing NCDs in Emergencies.
- WHO, UNHCR & Partners. (2024). Global High-Level Technical Meeting on NCDs in Humanitarian Settings: Meeting Report.
- World Health Organization (WHO). (2016). Non‑Communicable Diseases in Emergencies. https://iris.who.int/handle/10665/204627
- World Health Organization. (2010). Package of Essential Non‑Communicable (PEN) Disease Interventions for Primary Health Care in Low‑Resource Settings.
